Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

Hillevi Pendleton,Magnus Jannert,Oskar Hammar,Rolf Olsson,Bodil Ohlsson,Ola Thorsson,Marianne Ahlner-Elmqvist

doi:10.1186/1472-6815-13-11

Hillevi Pendleton, Magnus Jannert + Show 5 more

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https://doi.org/10.1186/1472-6815-13-11

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BackgroundLaryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL). Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to assess health-related quality of life (HRQOL) before and after treatment.MethodsForty-six patients (26 women), with verified PL, median age 55 (IQR 41–68) years, were referred to oesophago-gastro-duodenoscopy and 24-h pH monitoring. Plasma motilin was analysed. The 36-item Short-Form questionnaire was completed at inclusion and at follow-up after 43±14 months, when also the Visual Analogue Scale for Irritable Bowel Syndrome was completed. Values were compared to controls. Treatment and relief of symptoms were noted from medical records.ResultsThirty-four percent had proximal acid reflux and 40% showed signs of distal reflux. Ninety-four percent received acid-reducing treatment, with total relief of symptoms in 17%. Patients with reflux symptoms had lower plasma motilin levels compared to patients without reflux symptoms (p = 0.021). The HRQOL was impaired at inclusion, but improved over time. Patients, especially men, had more functional gastrointestinal symptoms than controls.ConclusionsThis study indicates that a minority of patients with PL has LPR and is cured by acid-reducing therapy. Disturbed plasma motilin levels and presence of functional gastrointestinal symptoms are found in PL. The impaired HRQOL improves over time.

Highlights

Laryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL)
A previous study indicate that 4%−10% of the patients who visit a Department of Oto-Rhino-Laryngology have complaints related to LPR [2]
Thirty-five patients tolerated the 24-h pH monitoring, 37 patients agreed to give blood samples for analysis of motilin, 42 patients were examined by OGD, and 44 patients filled in the 36-item Short-Form questionnaire (SF-36) questionnaire (Figure 1)

Summary

Introduction

Laryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL). Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to assess health-related quality of life (HRQOL) before and after treatment. One study showed that as many as 50% of patients affected by laryngeal and voice disorders have a pH-documented reflux [1]. Motilin is an intestinal hormone, which regulates the migrating motor complex (MMC) of the ventricle and affects the pressure of the LOS. Patients with reflux have been shown to have altered motilin levels [11]

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